Shoulder and Elbow OINAs

Question 1

Trapezius

Answer 1

➢ O: Superior nuchal line; external occipital protuberance; nuchal ligament; spinous
processes C7 – T12

➢ I: Acromion & spine of scapula; lateral 1/3 clavicle

➢ N: Spinal accessory nerve (CN XI) (motor), C3-4 (sensory)

➢ A: Elevation, depression, retraction, upward rotation scapula
▪ all three parts acting synergistically will retract scapula
* Upper: Elevation, upward rotation, retraction scapula
* Middle: Retraction scapula
* Lower: Depression, upward rotation, retraction scapula

Question 2

Levator Scapulae

Answer 2

➢ O: Transverse process C1-4

➢ I: Medial border scapula (superior to spine)

➢ N: Dorsal scapular n. (C3,C4)

➢ A: Elevation & downward rotation scapula
▪ Elevation, downward rotation scapula (proximal attachment fixed)
▪ Lateral flexion, ipsilateral cervical rotation (distal attachment fixed)

Question 3

Pectoralis Major

Answer 3

➢ O:
▪ Clavicular head: anterior surface medial half clavicle
▪ Sternocostal head: anterior surface sternum, superior 6 costal cartilages,
aponeurosis external oblique

➢ I: Lateral lip bicipital groove humerus (PLT)

➢ N: Lateral and medial pectoral nerves,
▪ Clavicular head: Lateral pectoral n. (C5,C6,C7)
▪ Sternocostal head: Medial pectoral n. (C8,T1)

➢ A: Both heads: Adduction (horizontal), IR of shoulder; draws scapula
anteriorly, inferiorly
▪ Clavicular head: Flexion shoulder
▪ Sternocostal head: Extension shoulder

Question 4

Pectoralis Minor

Answer 4

➢ O: Ribs 3–5 near costal cartilages

➢ I: Coracoid process scapula

➢ N: Medial pectoral nerve (C8,T1)

➢ A: Depression, protraction scapula
▪ (Stabilization scapula drawing inferiorly, anteriorly against thoracic wall)

Question 5

Serratus Anterior

Answer 5

➢ O: Lateral parts ribs 1-8

➢ I: Anterior surface medial border scapula

➢ N: Long thoracic nerve (C5,C6,C7)

➢ A: Protraction scapula, holds scapula against thoracic wall, upward rotation
scapula

Question 6

Rhomboid Major

Answer 6

➢ O: Spinous processes T2-T5

➢ I: Medial border scapula (inferior to spine)

➢ N: Dorsal scapular (C4,C5)

➢ A: Elevation, retraction, downward rotation scapula; scapular stabilization against
trunk with UE movement

Question 7

Rhomboid Minor

Answer 7

➢ O: Nuchal ligament; spinous processes C7-T1

➢ I: Medial end scapular spine

➢ N: Dorsal scapular (C4,C5)

➢ A: Elevation, retraction, downward rotation scapula; scapular stabilization against
trunk with UE movement

Question 8

Deltoid

Answer 8

➢ O: Lateral 1/3 clavicle; acromion, spine scapula

➢ I: Deltoid tuberosity of humerus

➢ N: Axillary nerve (C5,C6)

➢ A:
▪ Anterior head: flexion, medial rotation (IR) shoulder
▪ Medial head: abduction shoulder
▪ Posterior head: extension, lateral rotation (ER) shoulder

Question 8

Teres Major

Answer 8

➢ O: Inferior angle scapula

➢ I: Medial lip bicipital groove (PLT)

➢ N: Lower subscapular nerve (C5,C6)

➢ A: Adduction, medial rotation, extension shoulder

Question 8

Coracobrachialis

Answer 8

➢ O: Coracoid process scapula

➢ I: Middle 1/3 medial surface humerus

➢ N: Musculocutaneous n. (C6,C7)

➢ A: Flexion, adduction shoulder; resists shoulder dislocation

Question 9

Latissimus dorsi

Answer 9

➢ O: Spinous processes T7-12; thoracolumbar fascia; iliac crest; ribs 9-12

➢ I: Floor bicipital groove (PLT)

➢ N: Thoracodorsal nerve (C6,C7,C8)

➢ A: Extension, adduction, medial rotation shoulder

Question 10

Supraspinatus

Answer 10

➢ O: Supraspinous fossa scapula

➢ I: Greater tubercle humerus - superior facet

➢ N: Suprascapular nerve (C5,C6)

➢ A: Abduction shoulder; dynamic stabilization

Question 11

Infraspinatus

Answer 11

➢ O: Infraspinous fossa scapula

➢ I: Greater tubercle humerus - middle facet

➢ N: Suprascapular nerve (C5,C6)

➢ A: Lateral rotation shoulder; holds humerus in glenoid cavity

Question 12

Subscapularis

Answer 12

➢ O: Subscapular fossa

➢ I: Lesser tubercle humerus

➢ N: Upper, Lower subscapular nerves (C5,C6)

➢ A: Medial rotation, adduction shoulder, holds humerus in glenoid cavity

Question 13

Teres Minor

Answer 13

➢ O: Lateral border scapula

➢ I: Greater tubercle of humerus - inferior facet

➢ N: Axillary nerve (C5,C6)

➢ A: Lateral rotation shoulder; holds humerus in glenoid cavity

Question 14

Subclavius

Answer 14

➢ O: Junction of 1st rib and costal cartilage

➢ I: Inferior surface middle 1/3 clavicle

➢ N: Nerve to subclavius (C5,C6)

➢ A: Anchors, depresses clavicle

Question 15

Biceps Brachii

Answer 15

➢ O:
▪ Short head: Coracoid process scapula
▪ Long head: supraglenoid tubercle scapula

➢ I: Radial tuberosity (fascia of forearm @ bicipital aponeurosis)

➢ N: Musculocutaneous nerve (C5,C6)

➢ A: Supination forearm; flexion elbow; short head resists dislocation of shoulder;
assists shoulder flexion

Question 16

Brachialis

Answer 16

➢ O: Distal half anterior surface humerus

➢ I: Coronoid process, tuberosity ulna

➢ N: Musculocutaneous n. (C5,C6)

➢ A: Flexion elbow

Question 17

Brachioradialis

Answer 17

➢ O: Proximal 2/3 lateral supracondylar ridge humerus

➢ I: Styloid process radius

➢ N: Radial nerve (C5,C6)

➢ A: Flexion elbow

Question 18

Triceps Brachii

Answer 18

➢ O:
▪ Long head: infraglenoid tubercle scapula
▪ Lateral head: posterior surface humerus superior to radial groove
▪ Medial head: posterior surface humerus inferior to radial groove

➢ I: Proximal end olecranon process (fascia of forearm)

➢ N: Radial nerve (C7,C8)

➢ A: Extension elbow, long head: extension shoulder; resists dislocation of shoulder

Question 19

Anconeus

Answer 19

➢ O: Lateral epicondyle humerus

➢ I: Lateral surface olecranon process, superior/posterior surface ulna

➢ N: Radial nerve (C7,C8)

➢ A: Assists extension, stabilization elbow

Question 20

Pronator Teres

Answer 20

➢ O: Medial epicondyle, coronoid process ulna

➢ I: Middle lateral surface radius

➢ N: Median nerve (C6,C7)

➢ A: Pronation forearm, flexion elbow